Nashua / Hudson NH Dentists
603-882-995530 Lowell Road
Hudson, NH

TEETH WISDOM / A GENERAL DENTAL INFORMATION BLOG

Drs. Joe and Dori Columbus DDS Have Performed Thousands of Dental Procedures During Their Careers, Continually Update Their Dentistry Skills and LearnAbout New Products and Materials, and Are Happy to Share Their Wisdom About Teeth With You.


Why Do I Do Botox?

Posted by Dori Lang Columbus DDS

April 5, 2017

I am a general dentist, so why do I do Botox?

Like many of us, I started to see my face aging as I got older, with an increase in lines and furrows, making me look tired, and less youthful, all of the time.

I had always referred Botox treatment out to the medical community, and was hesitant to go deeper into it, until a colleague pointed out that dentists inject into the face more than do any other medical provider… including plastic surgeons!

During our training in dental school, students are required to complete an extensive dissection of the human body (cadaver), with more emphasis on the head and neck anatomy than what most medical students are exposed to. We are the experts in head and neck anatomy, not just the teeth.

Why Do I Do Botox?

So, with the intent of being able to provide cosmetic services for both myself, and my patients, I learned how to administer Botox. My fellow students included a lot of registered nurses, most with no advanced head or neck background – some of them even came from obstetric, pediatric, and primary care physician practices! Only dentists participating had in-depth knowledge of facial anatomy.

Having spent years giving (almost) painless injections in the oral cavity, I found I was adept at administrating Botox with little discomfort to my patients. The results are amazing, and my patients love how much younger, relaxed, and refreshed they look.

Thanks to my dental training, I am better at administering Botox than most of the people who do it, and I love making patients happy. That’s why I do Botox.

Dori Lang Columbus, DDS


Your Dental Insurance Explained

Posted by Dori Lang Columbus DDS

March 15, 2017

We just came off one of the big candy holidays of the year – Valentine’s Day – and Easter is not far off. Easter is also a big candy holiday, which got me thinking about candy’s contribution to cavities.

Guess what is the most common question we get here at Columbus Dental Care? (I suspect every other dentist gets it, too.) It’s this one: Why doesn’t my dental plan pay for this dental treatment?

Now you know you’re not the only one, but it probably doesn’t make you feel any better. So let’s see, since knowledge is power, if I can give you a little power to make your dental plan better, if you can. Or at least get you out of the dark about your coverage…

There are many, many dental plans available, and having one can make it easier to get the care you need. But almost all dental plans are a contract between your employer and a dental insurance company, and very few of them cover all the procedures you might need.

Your employer determines how much it wants to spend on the premium to provide this benefit to you and your fellow employees. Your employer negotiates with an insurance company based on the premium your employer is willing to pay, and that determines the type and amount of coverage that your dental plan will provide.

Dental insurance companies employ many ways to minimize the amount of money that they have to pay out. Cost-control measures they use include:

UCR (Usual, Customary, and Reasonable) Charges

This is the maximum amount your insurance company thinks a procedure is worth. UCR implies that there is a “standard” fee schedule, or ‘”going rate” for a dental procedure, which is not the case. The terms “usual”, “customary” and “reasonable” are misleading for several reasons:

  • Insurance companies randomly set their UCR fees, which frequently do not match the actual fees charged by dentists in a given area.
  • The UCR fees may stay the same for many years, because insurance companies may be slow to adjust for inflation or the changing cost of providing dental care, or advances (and even differences) in treatment.
  • Every insurance company has its own formula that they use to set their UCR rates, and they are not required to disclose the method by which their UCR fees are determined.

Just because your dental bill is higher than the UCR of the insurance carrier does not mean a particular dentist is charging too much. It could mean that the insurance company has not updated its UCR fee scheduled, or that the data used to establish the UCR fee scheduled has been taken from a different location than the one you are in.

Annual Maximums

This is the maximum dollar amount a plan will pay in one calendar year. Again, the annual maximum dental benefit is determined by your employer in its contract with your insurance company. These allowances are lost at the end of the of the contract year and do not roll over to the next calendar year. If you don’t use them, you lose them. In many cases, these maximums have not been raised for decades.

Pre-Existing Conditions

You have certainly heard about this one. In the case of dental plans, as an example, your insurance may choose not cover to replace a missing tooth if that tooth was missing prior to your enrollment. This does not mean that the tooth does not need to be replaced. This is just another way insurance companies use to get out of paying for needed treatment.

Not Dentally Necessary

This clause in many dental plans gives the insurance company the option of refusing to cover procedures they deem not medically or dentally necessary. But an insurance company does not know you as an individual, and their view of “dentally necessary” may not coincide with the opinion of your dentist. You and your dentist should make your treatment decisions, not your dental insurance plan.

Plan Frequency Limitations

Some dental plans will limit the number of times that a particular procedure will be reimbursed. For example, most insurances will pay for 2 cleanings per year, but many people with gum and other issues would benefit from cleaning three or more times a year. (This, in the long run, should cost the insurance companies less than it does to repair the results of lax preventive care. But nobody ever accused insurance companies of thinking ahead that way.)

The “Preferred Provider”

During the last decade or so, dental insurers have increasingly promoted the concept of the “in-network” provider. A doctor who is in “in-network” has agreed to offer a significant discount to patients with that particular insurance. Some plans only pay “in-network” dentists. Other plans will allow the patient to see the dentist of their choosing, but reimburse the dentist at the discounted rate, and the balance not paid is your responsibility.

So what can you do?

At Columbus Dental Care, our primary goal is to help you establish and maintain excellent dental health. And we also work diligently to help you obtain the most from your dental insurance by filing your claims on your behalf.

We often see patients with large-scale dental problems, and for these patients, dental insurance helps only marginally - they reach their yearly maximums very quickly. But putting off needed treatment can lead to bigger (and more expensive) dental problems. It’s important to address all aspects of dental disease in a timely fashion, regardless of what insurance will or will not pay.

It’s also important to keep in mind that there are good dental insurance plans, and not-so-good ones. If you are not satisfied with your dental insurance coverage, let your employer know.


The Causes of Cavities

Posted by Dori Lang Columbus DDS

February 15, 2017

We just came off one of the big candy holidays of the year – Valentine’s Day – and Easter is not far off. Easter is also a big candy holiday, which got me thinking about candy’s contribution to cavities.

Candy is a culprit, but there are many others, so here is my list of the Top 10 reasons for tooth decay:

  1. Poor Oral Hygiene: The biggest reason for tooth decay is poor oral hygiene. Dental plaque, loaded with acid-producing bacteria, forms very quickly and can start eroding tooth enamel on contact. If plaque is not removed daily, a cavity can get started and advance through the layers of the tooth, from the hard outer enamel surface, through the softer dentin, and finally to the nerve (pulp) center of the tooth. Brushing a minimum of two times a day and flossing regularly is the best defense for avoiding tooth decay.
  2. Sugary Foods: Sodas, candy, cereals and most juices are loaded with sugar, which is also food for the acid-producing bacteria that hasten tooth decay.
  3. Acidic Foods: Acidic foods and juices, and carbonated beverages, can damage the tooth enamel directly and immediately with their own acids. Juices and carbonated sodas are the biggest culprits.
  4. Improper Nutrition: Foods high in sugar, foods high in simple carbohydrates and high in acids contribute to tooth decay. Eating a healthy diet, including fruits and vegetables, can help decrease cavity formation.
  5. Crevices and Enamel Issues: Deep grooves in some teeth, especially the molars, can allow bacteria to hide and proliferate. Dental sealants placed in these grooves is a fantastic tool for reducing dental caries on the biting surfaces of teeth.
  6. Dry Mouth: Saliva functions to help wash teeth, and clean and dilute the acidity in your mouth. People with dry mouth issues, usually due to genetics, medications, or old age, are more at risk for cavities. Chewing gum with xylitol can stimulate the mouth and help it be less dry, which helps fight cavities.
  7. Grinding: Grinding of the teeth (bruxism) can cause fracturing of the tooth enamel, which increases the incidence of dental caries. A mouth guard worn at night (when most grinding occurs) can greatly relieve this problem.
  8. Genetics: We inherit the shapes of our teeth, as well as the grooves previously mentioned. Crowded teeth, which can make brushing or flossing more challenging, is also an inherited trait which can contribute to more cavities.
  9. Age:  We all get old (hopefully), and with increased age there can be an increase in cavities as well. Recession exposes roots to the acidic oral environment and can quickly lead to root decay. Also, manual dexterity can compromise brushing, saliva production can decrease and medications can cause dry mouth.
  10. Avoiding the Dentist: Routine dental visits are very important to prevent dental decay. Routine cleanings, oral hygiene instructions, early cavity detection, sealants, and fluoride application are just some of the many ways going to the dentist can prevent tooth decay from becoming a problem for you.

I encounter many of the problems listed above when I travel to Uganda to provide dental services to people in poor rural villages. Access to dental care, to toothbrushes and pastes, and even to clean water, can be very difficult there. Many Ugandans drink soda instead of water, because it’s safer. But not for their teeth.

Here in the US, we have clean water, an abundance of healthy foods, and dozens of brands of toothbrushes and toothpastes from which to choose. You also have me, Dr. Joe, and the entire staff at Columbus Dental Care always at the ready to make sure your smile is the best it can be.


Implants vs. Fixed Bridges & Removable Partials

Posted by Joseph V. Columbus DDS

November 18, 2016

A missing tooth might seem like just an inconvenience if it happens to be out of sight of your smile. Unfortunately, the truth is it can be devastating to your overall oral health in the future. 

Your teeth are in a delicate balance in their positions, and can move over time. That's why braces work to improve your smile and chewing. We capture nature's forces and direct them so your teeth end up in the proper position.

A missing tooth changes the balance, and that starts the uncontrolled movement of your teeth.  Some are lucky enough that the balance returns without much damage, but others are not. Shifting teeth can lead to too much force on the surrounding teeth, resulting in fractures of fillings or a tooth itself, leading to more extensive and expensive treatment.

Opposing teeth can also shift into the space left by a missing tooth,  creating areas that are difficult to clean. This can lead to gum disease and possible further tooth loss, not to mention problems with your jaw joint and the muscles that control chewing.

Implants
Partials

With all those possible outcomes, replacing a missing tooth can be the least-expensive way to save you a lot of problems and money down the road, and dental implants are the best way to that.

Fixed-in-place bridges and removable partial dentures still have their place in the possible treatment options for missing teeth, but dental implants, where possible, can give you a natural and more easily-maintained result.

With dental implants, we can replace the missing tooth or teeth without having to work on the surrounding teeth, saving you the expense of maintaining those restorations for the rest of your life.

Dental implants won't decay, and once integrated into the bone (about 4 months after placement) they can last you a very long time and allow you to clean your teeth better. You can brush and floss an implant just like it was your natural tooth.

We strongly suggest dental implants as the best option to replace a missing tooth, in almost all cases. They can save you money down the road, with less maintenance and replacement over your lifetime. If you have a missing tooth, or need to have a tooth removed, come see us to discuss a dental implant replacement.


We Are So Fortunate

Posted by Dori Lang Columbus DDS

October 20, 2016

I often travel to Uganda on missions to provide dental services, most-recently to the people of Mitala Maria, in the central part of the country. It's a place with little or no reliable electricity, running water, or sanitary facilities, not to mention paved roads, drive-thru restaurants and shopping malls.

On my way back from my last trip, I got to thinking about that, and about how lucky I am – we are – to live in the United States.

In the United States, families have access to the best medical and dental care in the world, and the oral health section in any supermarket or drugstore has hundreds of choices of toothpaste, brushes and floss. In Mitala Maria, I was the first dentist the villagers had ever seen. And toothbrushes? Read on…

The dental needs of the people in Mitala Maria are extensive, ranging from heavy plaque deposits to many missing teeth to sever periodontal disease and bone loss.

In order to be seen by me, many people traveled hours, often by boat and then by boda-boda (motorbike), over poorly maintained roads. They then waited in line for many more hours to be treated. 

Compare that to your short drive in a comfortable car, to a relaxing waiting room with big screen television, toys for your kids to play with and an extensive selection of magazines to occupy you during what, at Columbus Dental Care, is no more than a 5-minute wait to be seen by a hygienist or doctor.

In America, we have the latest and greatest dental equipment: high-tech sterilization, digital x-rays, ultrasonic cleanings, CAD/CAM restoration systems and more, plus entirely reliable water, waste, electricity and communications infrastructures to support what we do.

In Mitala Maria, electricity is supplied on a rolling grid and not always available. Water needs to be boiled to be safe to drink. I sterilized my instruments in water set to boiling on a coal-burning stove, and did my work the old-fashioned way, with manual scalers, dental mirrors, cups of water to rinse, and great care.

You and I can buy a good toothbrush in America for a couple of dollars. In most of Uganda, toothbrushes are not readily available and cost more money than most of the people I saw in Mitala Maria can ever afford, so we showed them how to create rudimentary toothbrushes from palm fronds, which, when employed with a slurry of ash, could be used to remove build-up and plaque, to reduce dental caries (cavities) and tooth loss.

I really cannot imagine what it must be like for the mothers of this region.  There is no health care readily available, and the only dental offices I saw were in the big cities of Kampala and Entebbe.  If your child is swollen with a dental infection, there is nowhere to go. 

Dental Photo

It is so easy and takes almost no time to go from a condition of build-up like you see on the young boy pictured, to caries and tooth pain that even keeps him from chewing on that side, leading to more tartar and plaque, eventual tooth loss, and maybe far worse. But treatment costs money. There are no jobs, hence there is no money. 

So I bring this back to how lucky I am, and thankful that my children, or yours, can be treated when treatment is necessary. And at Columbus Dental, we do everything we can to make sure that good preventive and restorative dental care is not beyond the means of any patient.

Good overall health starts with good dental health – the ability to chew, to smile, to kiss, and to be happy, are all tied into your teeth. So I'll just end by saying…

Brush and floss at least twice a day. Get your teeth professionally cleaned twice a year. It's easy, and it costs far less to prevent expensive dental issues than it does to fix them. Lastly, buy yourself a new toothbrush and use it well, but a palm frond and some ash will do the trick, if necessary.


Don't Fear the Dentist!

Posted by Dori Lang Columbus DDS

August 8, 2016

Dr. Joe and I have been in dental practice for more than a quarter of a century, and so have seen an amazing number of changes in dentistry – in materials, technology, tools and procedures.

A couple of things haven't changed during the years we've been seeing patients, though: a lot of people are still afraid to see the dentist, and the average dental insurance benefit is still stuck at about a 1970s level of $1,000-$2,000 per year.

In the 1970s, that was often more than enough to cover the costs of even many "involved" cases, with cavities, perhaps an extraction, and multiple crowns. But today's technology hasn't come cheap, the cost of dental education has skyrocketed, office space can be very expensive, and so is maintaining your privacy against internet hackers.

Back to the first thing I mentioned that hasn't changed: fear of seeing the dentist. That used to be about pain. Now, it seems, it's more about seeing the dentist's bill, especially for those who have no dental insurance at all.

Fortunately, Dr. Joe and I both feel that no one should have to avoid the us due to fear of paying for our services. We have hundreds of patients without insurance, and go out of our way to offer the best dental care money can buy, as affordably as possible, with many options for payment.

There's also a silver lining (better yet, a tooth-colored lining) to our approach - good dental health doesn't have to be very expensive for most people.

Starting in childhood, a  couple of good check-ups with thorough, gentle cleanings, and an annual set of x-rays, is all many people ever need. Seeing us twice a year, every year, allows us to monitor your dental health consistently, and to make smaller, inexpensive corrections that help you to avoid serious, expensive problems later on.

Think of it this way…

I'll bet you maintain your vehicle. You gas it up once a week; get one or two oil changes a year, depending on how many miles you drive; have an annual inspection; and every now and then replace the wiper blades, or the tires, or the brakes. Maybe you have a fender bender and have to get things straightened out. And if you're lucky, you may keep that car five or ten years.

Well, if you brush and floss regularly (toothpaste costs a lot less than gasoline); see us for check-ups and cleanings twice a year; have an annual x-ray; and occasionally maybe get a filling, or a little bonding, or even need to get your teeth straightened out, they are likely to last you a lifetime.

That's a pretty smart investment. And we promise to make it as painless as possible.

Do you have a dental problem or concern you would like to see Dr. Joe or Dr. Dori write about in this dental blog? Send an Email to let us know, and we’ll do our best.

Link is: columbusdentalcare@comcast.net

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